OIG includes meaningful use in 2013 reviews

In its investigations into Medicare and Medicaid fraud, the Office of the Inspector General, will also undertake Recovery Act reviews, which include probes into the EHR Incentive program.

“We will review Medicare incentive payments to eligible health care professionals and hospitals for adopting electronic health records (EHR) and the Centers for Medicare & Medicaid Services (CMS) safeguards to prevent erroneous incentive payments," the OIG states in its work plan for fiscal year 2013.

In its plan OIG states it will look at incentive payments CMS made beginning in 2011 to identify payments to providers that should not have received incentive payments – those that did not meet the meaningful use criteria.

Incentive payments were scheduled to begin in 2011 and continue through 2016, with payment reductions to healthcare professionals who fail to become meaningful users of EHRs beginning in 2015.

According to the Congressional Budget Office (CBO) estimates, CMS’s net spending for incentives will total about $20 billion.

The OIG will also assess CMS’s plans to oversee incentive payments for the duration of the program and actions taken to remedy erroneous incentive payments, according to the OIG work plan.

The OIG was created to protect the integrity of HHS programs and operations and the wellbeing of beneficiaries by detecting and preventing fraud, waste, and abuse; identifying opportunities to improve program economy, efficiency, and effectiveness; and holding accountable those who do not meet program requirements or who violate Federal laws, according to OIG.

This past week, four Republican senators wrote to Health and Human Services Secretary Kathleen Sebelius asking for a meeting with officials from the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health Information Technology to discuss matters related to meaningful use.

Senators John Thune (R-SD), Tom Coburn (R-OK), Richard Burr (R-NC) and Pat Roberts (R-KN) requested information about whether EHR adoption has an outsized increase in physians' Medicare billing, whether some providers received subsidies for EHR systems that were in place before the MU program and whether EHR systems have meant an uptick in clinical tests.